先天性心脏病小儿MSCT心脏成像后血管空气栓塞分析  

Analysis of vascular air embolism in MSCT cardiac imaging of children with congenital heart disease

作　　者：吴倩 周佩 熊飞 谭惠斌 邹佳妮 黄文才 王玉庆 WU Qian;ZHOU Pei;XIONG Fei(Department of Radiology,General Hospital of Central Theater Command,Wuhan 430070,China)

机构地区：[1]中部战区总医院放射科,武汉437000

出　　处：《放射学实践》2023年第7期942-946,共5页Radiologic Practice

摘　　要：目的:分析接受MSCT心脏成像检查的先天性心脏病(CHD)小儿发生血管空气栓塞(VAE)的原因、风险及预防方法。方法:连续纳入490例CHD小儿MSCT心脏成像资料,记录空气栓子出现部位、大小、形状及数量,评估CHD小儿VAE发生率和相关风险因素。结果:VAE发生率为9.2%(45/490),45例VAE中发生于右心房66.7%(30/45)、主肺动脉22.2%(10/45)、右心室11.1%(5/45)、主动脉根部6.6%(3/45)、左锁骨下静脉2.2%(1/45)、左心室2.2%(1/45);静脉系统VAE 91.1%(41/45),动脉系统VAE 8.9%(4/45);单处88.9%(40/45),多处11.1%(5/45);小量VAE 75.6%(34/45),中等量VAE 24.4%(11/45),无大量VAE。共发现90个气泡,圆形或类圆形57.8%(52/90),不规则形42.2%(38/90)。发生VAE组与未发生VAE组患儿的年龄、身高、体重、性别、有无心内或肺内分流、静脉留置针型号及对比剂注射流率、剂量、类型、回流路径差异均无统计学意义(P>0.05)。结论:CHD小儿MSCT心脏成像检查中VAE发生率低且多数空气栓子较小、多无症状,但仍存在较高潜在医疗风险需引起重视,在检查过程中应仔细排气并运用一些操作技巧及措施以避免其发生。Objective:To analyze the causes,risks and prevention of vascular air embolism(VEA)of children with congenital heart disease(CHD)who received MSCT cardiac imaging examination.Methods:490 children with CHD who underwent MSCT cardiac imaging examination were successively included.The location,size,shape,and number of air embolus were recorded,and the incidence of VAE and related risk factors in children with CHD were evaluated.Results:The incidence rate of VAE was 9.2%.Among the 45 cases,air embolus located in the right atrium in 30(66.7%),main pulmonary artery in 10(22.2%),right ventricle in 5(11.1%),aortic root in 3(6.6%),left subclavian vein in 1(2.2%)and left ventricle in 1(2.2%).Venous system in 41(91.9%),arterial system in 4(8.9%).Single air embolus was found in 40 cases(88.9%),multiple emboli in 5 cases(11.1%).Small amount of VAE was found in 34 cases(75.6%),medium amount of VAE in 11 cases(24.4%),and large amount of VAE wasn't found.A total of 90 bubbles were found.They were round or similarly round shape in 52(57.8%),anomalistic shape in 38(42.2%).There were no significant differences in age,height,weight,gender,intracardiac or intrapulmonary shunts,type of intravenous indwelling needle and the injection rate,dose,type,reflux path of contrast agent between the group with VAE and the group without VAE.Conclusion:The incidence of VEA is low and most of the air embolus was small.Although most VAEs are asymptomatic during MSCT cardiac imaging examination of children with CHD,there are still high potential medical risks that need to be paid attention to.So medical staffs should eliminate air carefully during the examination and take some techniques and measure to avoid its occurrence.

关 键 词：血管空气栓塞 先天性心脏病 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R726.04[医药卫生—放射医学]